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Context: The California Department of Education requires that kindergartners receive vision screening in preparation for school. Information is not available in the literature, however, on the prevalence of and factors associated with uncorrected refractive error (ie, the lack of eyeglasses), which is the primary cause of decreased visual acuity in children, among first-grade students of different racial/ethnic groups in California.

Objective: To determine the proportion of first-grade students with decreased visual acuity who need eyeglasses but do not have any and whether the lack of eyeglasses is associated with racial/ethnic and other factors.

Setting: Three school districts in Southern California.

Participants: The University of California, Los Angeles Mobile Eye Clinic examined the eyes of 11 332 first-grade students over a 7-year period. Statistical analyses included adjusted logistic regression and linear trend models.

Findings: Among 11 332 first-grade students, 6973 (61.5%) were Latino, 1511 (13.3%) were Asian/Pacific Islander, 1422 (12.5%) were African American, 310 (2.7%) were non-Hispanic white, and 1116 (9.8%) were from other or mixed races/ethnicities. The prevalence of decreased visual acuity was 8.0%; 95% of children with decreased visual acuity (858 of 906 children) lacked eyeglasses that would have helped them attain normal vision. The lack of eyeglasses was more common in boys and African American/Latino children compared with that in girls and non-Hispanic white children, respectively. The percentage of children lacking eyeglasses over the years exhibited an increasing linear trend (R2 = 0.86).

Conclusions: Most first-grade students with decreased visual acuity, especially African American and Latino children, need eyeglasses but do not have any. Interventions to correct decreased visual acuity in first-grade students are important because the first grade is a period of critical academic development.

This article determines the proportion of first-grade students with decreased visual acuity who need eyeglasses but do not have any and whether the lack of eyeglasses is associated with racial/ethnic and other factors.

UCLA Jules Stein Eye Institute, and the Department of Ophthalmology, David Geffen School of Medicine (Drs Kodjebacheva, Coleman and Yu), UCLA School of Public Health, Departments of Health Services (Dr Brown), Biostatistics (Dr Yu), and Epidemiology (Dr Coleman), Department of Urban Planning, School of Public Affairs (Dr Estrada), and Center for Health Policy Research (Dr Brown), University of California, Los Angeles (UCLA), Los Angeles.